A 13-year experience with peritoneal drainage under local anesthesia for necrotizing enterocolitis perforation

J Pediatr Surg. 1990 Oct;25(10):1034-6; discussion 1036-7. doi: 10.1016/0022-3468(90)90213-s.


Between 1974 and 1986, inclusive, over 400 newborns with clinical, radiological, and/or pathological evidence of necrotizing enterocolitis (NEC) were treated at the Hospital for Sick Children, Toronto, Ontario. Within this group were 37 babies who had a bowel perforation that was treated with peritoneal drainage under local anesthesia. Eighty-eight percent of the 41 weighed less than 1,500 g and 65% weighed less than 1,000 g; during the same time 40 other neonates (9% of the total) with perforated NEC had laparotomies. Twelve neonates (32%) required only drainage with complete recovery of their intestinal tracts. The remaining 25 (68%) fell into one of three groups: (1) nine (24%) had rapid downhill course, sepsis, and death without laparotomy; (2) nine (24%) had rapid downhill course, sepsis, and laparotomy (five deaths); (3) seven (20%) had slow development of bowel obstruction requiring operation (two deaths). The overall survival rate was 56%. These results continue to indicate that this method is effective in temporizing 88% of the small and/or very ill babies with a NEC perforation. However, an added bonus is that 32% of these newborns treated in this fashion had complete resolution of their disease.

MeSH terms

  • Anesthesia, Local
  • Drainage / methods*
  • Enterocolitis, Pseudomembranous / complications
  • Enterocolitis, Pseudomembranous / therapy*
  • Humans
  • Infant, Newborn
  • Intestinal Perforation / etiology
  • Intestinal Perforation / therapy*
  • Pneumoperitoneum
  • Retrospective Studies